Provider Demographics
NPI:1841730207
Name:CAMEL BUAIZ, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CAMEL BUAIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 NW 104TH AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4476
Mailing Address - Country:US
Mailing Address - Phone:786-448-8496
Mailing Address - Fax:
Practice Address - Street 1:7925 NW 104TH AVE APT 7
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4476
Practice Address - Country:US
Practice Address - Phone:786-448-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10188106E00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician